Discussion

Research Question

Sep 29, 201510 yr

I failed in my first attempt of my research question and my tutor left me this comment.*you need to resubmit addressing the comments I have made. Also, you need to watch your grammar. Maybe ask your CNE or other senior nurse to read your assignment. You have chosen a good topic, however, you need to ensure you have sufficient resources to justify your question* Please tell me what is wrong with my proposed research question entry. Any revisions on my work is highly appreciated. Thank you

Research Question worksheet

[TABLE]

[TR]

[TD]Student name

[/TD]

[TD]Course/Subject

[/TD]

[/TR]

[TR]

[TD]xyz[/TD]

[TD]920-Professional Practice in Acute care nursing[/TD]

[/TR]

[/TABLE]

Describe the topic/issue for investigation

[TABLE]

[TR]

[TH]Description:

[/TH]

[/TR]

[TR]

[TD]Insertion of nasogastric tube has been one of the interventions in decompressing a person stomach to prevent any complications or provide nutrition. It is usually highly recommended for a patient that has bowel obstructions or any patient that underwent surgical intervention, which then requires relaxation of the stomach for a certain period of time. This is mostly achieved by using a nasogastric tube or known as NGT. There are various methods that are practically recommended by various clinical facilities in Australia and overseas. These can involve using radiography or other acceptable methods. However, there are two methods that are easy to use when confirming the placement of NGT without the intervention of radiography. These methods are widely used by nurses and doctors in clinical settings in Australia and abroad. It is either through the use of â€˜whoosh test' or auscultation and using a gastric pH balance.

The first method is what most of the healthcare staffs had been performing, this is a traditional method that is performed in the confirmation of nasogastric tube by nurses in various hospital settings. Mostly these are done in clinical settings that has less access to radiograph equipments or in emergency scenarios. This method is sometimes called â€˜whoosh test' or known as auscultation, our mentors have used it for a very long time. Nurses or doctors perform this by listening to the whooshing sounds over the stomach after introducing air into the tube by using a stethoscope (Mallett, J, Albarran, JW and Richardson, Annette 2013, p1963). Because of this, the nurse that is performing the method will figure out that the tube is in the stomach upon hearing a gurgling sound. Through hearing the gurgle, it will allow the nurse to initiate the usage of the tube either for decompression or commence of the feeding.

The other method is by checking the acidity of the gastric post-insertion of the nasogastric tube is the other technique that is performed by nurses, doctors and even dieticians in checking for the position of the tube. This is applying an aspirated gastric content into a litmus paper or pH test strips or dipping it into a fluid from the stomach and measure the acidity. The acceptable pH indicator in Australia is less than 5 or it may depend on the type of brand that is recommended by the product literatures. Once the pH level is verified, then the tube can be use by nurses or doctors. Universally, using pH paper is the first-line method in confirming the position of the tube, and a pH level that is between 1 and 5.5 is the acidity that indicates that the aspirated content is not from the pulmonary system, which then considered as appropriate (Dougherty, L and Lister, S 2015, p283). Majority of the clinicians prefer to use this in checking the placement of NGT.

Aspiration and pH testing have the same aim in identifying the patency of an NGT. Both methods aimed the same goal in the placement of an NGT. However, there are contrasting ideas as to the most appropriate and reliable test in the confirmation of the NGT. There are various studies that has been conducted and reviewed by different clinical researchers that will make one method to another in identifying if which is the most accurate and safe to perform in determining the placement of NGT.

In conclusion, aspiration and pH testing has similar purpose, which is to check for the correct placement of an NGT in a patient. But it is done in different way in performing the accuracy of the placement. So identifying the accurate methods in the placement of nasogastric tube depends on its reliability when it comes to the safety of the patient in any clinical settings.

[/TD]

[/TR]

[/TABLE]

PICO format for developing a research question*:

[TABLE]

[TR]

[TH]PICO element

[/TH]

[TH]Description

[/TH]

[/TR]

[TR]

[TD]Population

Define who or what the question is about, eg: age, gender, disease type, disease severity, or co-morbidity

Tip: describe a group of patients similar to yours[/TD]

[TD] Both adult and pediatric inpatients, which will include both men and women that require insertion of nasogastric tube in clinical settings.[/TD]

[/TR]

[TR]

[TD]Intervention

Define which intervention, test or exposure you are interested in:

â€¢ An intervention is a planned course of action.

â€¢ An exposure is something that happens such as a fall, anxiety, exposure to house dust mites, etc

Tip: describe what it is you are considering doing or what it is that has happened to the patient[/TD]

[TD]Measuring the pH level of gastric in determining the placement of nasogastric tube using an acceptable universal range from a pH indicator strip. [/TD]

[/TR]

[TR]

[TD]Comparison

Define the alternate intervention, if there is one

Tip: describe the alternative that can be compared with the intervention[/TD]

[TD]Auscultation by allowing a blown air using catheter tip syringe and listening to the sound that is generated by an introduced air in determining the correct placement of the nasogastric tube. [/TD]

[/TR]

[TR]

[TD]Outcome

Define the important outcomes, beneficial or harmful

Tip: define what you are hoping to achieve or avoid[/TD]

[TD] Determine the appropriate and safe method in identifying the right placement of nasogastric tube.[/TD]

[/TR]

[/TABLE]

*Use table 3.5 (on the next page) to define the question â€˜type' you are investigating.

Table 3.5: What type of question/problem are you investigating

[TABLE]

[TR]

[TH]Question type

[/TH]

[TH]Definition

[/TH]

[TH]Template

[/TH]

[/TR]

[TR]

[TD]Intervention or therapy[/TD]

[TD]To determine which treatment leads to the best outcome[/TD]

[TD]In â€¦ (P), how does â€¦ (I) compared with â€¦© affect â€¦(O)?[/TD]

[/TR]

[TR]

[TD]Aetiology[/TD]

[TD]To determine the greatest risk factors or causes of a condition[/TD]

[TD]Are â€¦ (P) who have â€¦ (I), compared with those without â€¦ © at risk of â€¦ (O)[/TD]

[/TR]

[TR]

[TD]Diagnosis or diagnostic test[/TD]

[TD]To determine which test is more accurate and precise in diagnosing a condition[/TD]

[TD]In â€¦(P) are/is â€¦(I) â€¦compared with â€¦© more accurate in diagnosing â€¦ (O)?[/TD]

[/TR]

[TR]

[TD]Prognosis or prediction[/TD]

[TD]To determine the clinical course over time and likely complications of a condition[/TD]

[TD]In â€¦ (P) how does â€¦ (I) â€¦ compared with â€¦ © influence â€¦ (O)?[/TD]

[/TR]

[TR]

[TD]Meaning[/TD]

[TD]To understand the meaning of an experience for a particular individual, group, or community[/TD]

[TD]How do â€¦ (P) with â€¦ (I) perceive â€¦ (O)?

(In this example there is no comparison)[/TD]

[/TR]

[/TABLE]

Adapted from: Stillwell et.al. 2010 Asking the Clinical Question: A Key Step in Evidence-Based Practice. AJN 110, 3, 60

Define your final question:

[TABLE]

[TR]

[TH]Define your final version of you research question in the PICO format:

[/TH]

[/TR]

[TR]

[TD] Among pediatric and adult inpatient with nasogastric tube, does aspirated pH testing compared to auscultation verify accurate placement after the insertion of nasogastric tube.

[/TD]

[/TR]

[/TABLE]

List the main search terms and alternate terms identified in your PICO question:

[TABLE]

[TR]

[TD]Search terms

[/TD]

[TD]Alternate terms

[/TD]

[/TR]

[TR]

[TD]Nasogastric tube[/TD]

[TD]NGT or large bore tube or fine bore tube[/TD]

[/TR]

[TR]

[TD]pH testing [/TD]

[TD]Litmus paper or pH paper or pH measurement[/TD]

[/TR]

[TR]

[TD]Auscultation[/TD]

[TD]Syringe test or whoosh test or gurgle sounds[/TD]

[/TR]

[TR]

[TD][/TD]

[/TR]

[TR]

[TD][/TD]

[/TR]

[TR]

[TD][/TD]

[/TR]

[TR]

[TD][/TD]

[/TR]

[TR]

[TD][/TD]

[/TR]

[/TABLE]

List your criteria (e.g. age, gender, year of publication, language, full-text etc) for inclusion or exclusion of articles to search.

[TABLE]

[TR]

[TD]Inclusion criteria

[/TD]

[TD]Exclusion criteria

[/TD]

[/TR]

[TR]

[TD]Adults[/TD]

[TD]Infant[/TD]

[/TR]

[TR]

[TD]Men[/TD]

[TD]Neonates[/TD]

[/TR]

[TR]

[TD]Women[/TD]

[TD][/TD]

[/TR]

[TR]

[TD]Pediatric [/TD]

[TD][/TD]

[/TR]

[TR]

[TD][/TD]

[/TR]

[TR]

[TD][/TD]

[/TR]

[TR]

[TD][/TD]

[/TR]

[TR]

[TD][/TD]

[/TR]

[/TABLE]

List the research databases (CINAHL, Medline, Cochrane, Joanna Briggs, etc) you will search using the terms above.

[TABLE]

[TR]

[TD]Database source

[/TD]

[TD][/TD]

[/TR]

[TR]

[TD]Ovid Nursing[/TD]

[TD]ProQuest[/TD]

[/TR]

[TR]

[TD]Cochrane[/TD]

[TD]ScienceDirect[/TD]

[/TR]

[TR]

[TD]PubMed[/TD]

[TD]Sage Journals[/TD]

[/TR]

[/TABLE]

Type of study to include in search:

[TABLE]

[TR]

[TD]Study type

[/TD]

[TD]description

[/TD]

[/TR]

[TR]

[TD]Meta-analysis[/TD]

[TD]A meta-analysis of methods that determines the accuracy of the effectiveness of different methods in checking the placement of NGT by pH testing and auscultation.[/TD]

[/TR]

[TR]

[TD]Systematic review[/TD]

[TD]A systematic review in determining the right placement of nasogastric tube just after the insertion of an NGT. Methods that are included in the studies were auscultation, pH aspirates, magnetic detection and others.[/TD]

[/TR]

[TR]

[TD]Randomised controlled trial (RCT)[/TD]

[TD][/TD]

[/TR]

[TR]

[TD]Cohort study[/TD]

[TD][/TD]

[/TR]

[TR]

[TD]Editorial/Letter/opinion[/TD]

[TD]Covers the reliability of pH testing over the auscultatory method, which will have an observational study in major hospitals.[/TD]

[/TR]

[TR]

[TD]Other[/TD]

[TD]Also an observational study in comparing the pH tests a result that was conducted over a 9-month period.[/TD]

[/TR]

[/TABLE]

Congratulations, you will now have the basis for your literature review based on a researchable question. If you have any queries about the processes above please contact your tutor to discuss further.

References:

Mallett, J, Albarran, JW and Richardson, A 2013, p. 1963, Critical Care Manual of Clinical Procedures and Competencies, Wiley Blackwell, UK

Dougherty, L & Lister, S 2015, p. 283, The Royal Marsden Manual of Clinical Nursing Procedures, 9^th edn, John Wiley & Sons, UK

Quote

Sep 29, 201510 yr

I can see why your instructor called out grammar issues. Based on the above sample, you seem to have a persistent problem with subject-verb agreement related to plural/singular case (e.g., using 'is' rather than 'are') and verb tenses. You also have quite a few sentence fragments, such as the last line in your very first "description" paragraph. Words appear to be missing such as the last sentence in the 3rd 'description' paragraph.... which should have begun with either "A majority".... (BTW, this sentence needs to be referenced since you do not have evidence to draw this conclusion). You may be writing very quickly and just accidentally making simple mistakes. Your instructor's suggestion - about having someone else read your submissions before turning them in - is very good.

APA style doesn't come naturally to most students because it is so passive. However, one of the most essential elements is to NEVER make a statement about anything without providing a reference. As an author, the only things you don't have to reference are comments about the information that has been mentioned... such as "in summary, studies X & Y supported ____, while evidence from study Z ____"...

I know it's frustrating, but it will be very worthwhile to master APA and improve your writing skills. Even if you do not choose to continue your formal education, there will be many times in your career in which excellent writing skills will prove to be very valuable. It will be critical for career advancement.

Quote

Sep 29, 201510 yr

Author

Thank you for your comment. I made some revisions to my descriptions which can be found below. ALso, what else can I add in my description since my score in critical thinking is ver low. Do i need to write the methods to be used, limitations and samples of the literature review?

*****Insertions of a nasogastric tube aimed to prevent aspirations and complication through the decompression of the stomach. This most often recommended in a patient with bowel obstruction or those who underwent surgical intervention that may require an NGT. Mostly, the purpose of a nasogastric tube is by providing relaxation of the gut in a certain period of time. In addition, there are different methods used by various clinical facilities in Australia and overseas. Mainly these involve by using radiography or other acceptable methods. Due to plenty of options in different methods of verification, there are two common methods used in confirming the placement of NGT. Usually, nurses and doctors in clinical settings in Australia and abroad use these methods. Either using the â€˜whoosh test' or known as auscultation or using a gastric pH balance can achieve it.

The main purpose of this study is to determine the accuracy of different methods in nasogastric tube, which will include auscultation and checking the pH balance. To begin with, nurses or doctors usually use auscultation by listening to the whooshing sounds over the stomach using a stethoscope (Mallett, Albarran and Richardson 2013, p1963). This method known as â€˜whoosh test'.

Another method is by checking the acidity post-insertion of the nasogastric tube. Most often, applying aspirated gastric content in a litmus paper or pH test strips measures the acidity. Naturally the acceptable pH indicator in Australia is less than 5 or it may depend on the type of brand's literatures. Universally, using pH paper is the first-line method of confirming the position of the tube, and a pH level that is between 1 and 5.5 is the acidity that indicates that the aspirated content is not from the pulmonary system, which then considered as appropriate (Dougherty, L and Lister, S 2015, p283). In other words a confirmed pH level will verify nurses or doctors for the usage of the tube.

Aspiration and pH testing have the same aim in identifying the placement of an NGT. Both methods aimed the same goal in the placement of an NGT. However, there are contrasting ideas as to the most appropriate and reliable test in the confirmation of the NGT. There are various conducted and reviewed studies by different clinical researchers, which will identify the accuracy and safeness in the determination of NGT placement.

*****

Quote

Sep 30, 201510 yr

Experts

.Hi! Welcome to AN! The largest online nursing community!!!

We ask that all students show what their research has revealed to them. We are happy to help however we will not do the work for students.

We also ask that you reveal your country of origin. Nursing is different internationally and answers can change according to the country.

I get a feeling that English might not be your primary language.....I would seek out the assistance of a tutor.

Are your research questions using PICOT/PICO format?

Question Templates for Asking PICOT Questions:
P: Population/disease ( i.e. age, gender, ethnicity, with a certain disorder)
I: Intervention or Variable of Interest (exposure to a disease, risk behavior, prognostic factor)
C: Comparison: (could be a placebo or "business as usual" as in no disease, absence of risk factor, Prognostic factor B )
O: Outcome: (risk of disease, accuracy of a diagnosis, rate of occurrence of adverse outcome)
T: Time: The time it takes to demonstrate an outcome (e.g. the time it takes for the intervention to achieve an outcome or how long participants are observed).
Note: Not every question will have an intervention (as in a meaning question) or time (when it is implied in another part of the question) component.
For an intervention/therapy:
In _______(P), what is the effect of _______(I) on ______(O) compared with _______© within ________ (T)?
For etiology:
Are ____ (P) who have _______ (I) at ___ (Increased/decreased) risk for/of_______ (O) compared with ______ (P) with/without ______ © over _____ (T)?
Diagnosis or diagnostic test:
Are (is) _________ (I) more accurate in diagnosing ________ (P) compared with ______ © for _______ (O)?
Prevention:
For ________ (P) does the use of ______ (I) reduce the future risk of ________ (O) compared with _________ ©?
Prognosis/Predictions
Does __________ (I) influence ________ (O) in patients who have _______ (P) over ______ (T)?
Meaning
How do ________ (P) diagnosed with _______ (I) perceive ______ (O) during _____ (T)?

PICO questions

Are you using APA formatting for your papers?

Quote

Sep 30, 201510 yr

Experts

APA format/resources.....https://allnurses.com/nursing-student-assistance/apa-writing-style-583693.html

Quote

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